Cluster randomized control trial promoting child self-regulation around energy-dense food

Children with lower inhibitory control have greater weight gain over time and consume more snack food. Our goal was to test whether a pilot program based on enhancing self-regulation in preschool children could decrease consumption of energy-dense foods. Ninety-two preschool children were randomized to the intervention or control group. The intervention was a three-week, play-based program that focused on enhancing executive function skills and decreasing consumption of energy dense snack foods. Controls met for a similar length of time, but focused on dental hygiene, good sleep habits/routines, and physical activity. Primary outcome included calories consumed during the post-intervention "Eating in the Absence of Hunger" paradigm, controlling for baseline calories consumed. Inhibitory control was assessed using the "Day/Night" and "Less is More" tasks. There were no differences in post-intervention calories consumed between groups (p = 0.42). However, post-hoc analysis revealed a significant interaction between group and weight status (p = 0.04). In the intervention group, overweight/obese and healthy weight children consumed a similar number of calories (118.0 kcals vs. 124.1 kcals respectively, p = 0.64). However, in the control group, overweight/obese children consumed more than normal weight children (155.9 kcals vs. 103.6 kcals respectively; p = 0.01). With regards to inhibitory control, post-hoc analysis revealed a significant interaction between group and age (p = 0.03), with younger children in the intervention group scoring higher than younger children in the control group (0.93 vs 0.78 respectively, p = 0.007). No differences were observed between groups among older children (0.93 vs 0.96, p = 0.42). These types of programs for preschool children may help to temper consumption of excess calories among overweight/obese children. Further development and investigation of pediatric programs that prevent consumption of excess calories are warranted. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02077387.